The Importance of Quality Implementation for Research, Practice, and Policy. Factors that Affect the Quality of Implementation

02/01/2013

In order to understand the types of factors that influence the quality of implementation of prevention programs for children and adolescents, Durlak and DuPre (2008) conducted a systematic search of the literature. They identified 23 factors that had received consistent support in at least five different research studies. A list of these 23 factors, which can be divided into five major categories, is contained in Table 1. Furthermore, a consensus is present regarding the importance and wide applicability of these potential influences. Other reviews that have focused on health care (Greenhalph, MacFarlane, Bate, Kyriakidou & Peacock, (2005) child abuse and neglect, and domestic violence programs for adults (Stith et al. (2006), or both treatment and prevention programs for children and adults (Fixsen, Naoom, Blas©, Friedman & Wallace, 2005), have independently identified many of these same factors.

 

Table 2. Brief Summary of 14 Steps

and Four Temporal Phases Involved

in Quality Implementation

 

Phase One: Initial Considerations

Regarding the Host Setting

Assessment Activities

1. Conduct a Needs and Resources

Assessment

2. Assess the fit of the program with the

organization

3. Conduct a Capacity/Readiness Assessment

 

Decisions about Adaptation

4. How Should Fidelity and Possible

Adaptations be

Decided?

 

Capacity-Building Strategies

5. Obtain Explicit Buy-in from Critical

Stakeholders

6. Build General/Organizational Capacity

7. Recruit Implementation Staff

8. Effective Pre-Innovation Staff Training

 

Phase Two: Creating a Structure for

Implementation

 

Structural Features for Implementation

9. Create Teams Responsible for Quality

Implementation

10. Develop an Implementation Plan

 

Phase Three: Ongoing Structure Once

Implementation Begins

 

Ongoing Implementation Support Strategies

11. Technical Assistance/ Coaching/Supervision

12. Monitoring On-going Implementation

13. Supportive Feedback System

 

Phase Four: Improving Future Applications

14. 14. Learning from Experience

 

The relative importance of each factor and how different factors may interact to influence implementation has yet to be clarified, but it is important to consider their possible relevance in each situation. For example, some factors exist at the societal or community level such as political pressures or policy mandates, and the availability of funding; some are related to whether local practitioners perceive a need for the program and recognize its potential benefits, and other pertain to features of the organization conducting the program such as its work climate, openness to change, and task-orientation.

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